Perez-Villa Felix, Font Josep, Azqueta Manel, Espinosa Gerard, Pare Carles, Cervera Ricard, Reverter Joan C, Ingelmo Miguel, Sanz Gines
Hospital Clinic, IDIBAPS, Barcelona, Spain.
Arthritis Rheum. 2005 Jun 15;53(3):460-7. doi: 10.1002/art.21162.
To assess whether the presence of antiphospholipid antibodies is related to the incidence and progression of severe valvular dysfunction and the need for valve replacement in patients with systemic lupus erythematosus (SLE).
In this prospective, long-term followup study, the initial echocardiographic findings in a cohort of 61 consecutive SLE patients were compared with those of 40 matched controls. All patients were serially evaluated for 14 +/- 3 years and had a followup echocardiogram 8 +/- 3 years after the initial evaluation. Serial determinations of anticardiolipin antibodies and lupus anticoagulant were performed in all cases.
The number of SLE patients with valvular abnormalities increased from 39% to 73% between the initial and the followup echocardiography, but only 7 patients (12%) developed severe valvular regurgitation. Severe valvular regurgitation was significantly associated with the presence of high levels of IgG anticardiolipin antibodies (P = 0.001). The combined incidence of stroke, peripheral embolism, need for valve surgery, and death was 86% in patients with severe valvular regurgitation, compared with 25% in those without (P = 0.003).
In SLE patients, the presence of high levels of IgG anticardiolipin antibodies is associated with the development of severe valvular regurgitation and with a high incidence of thromboembolic events and the need for valvular surgery.
评估抗磷脂抗体的存在是否与系统性红斑狼疮（SLE）患者严重瓣膜功能障碍的发生率和进展以及瓣膜置换需求相关。
在这项前瞻性长期随访研究中，将61例连续SLE患者队列的初始超声心动图检查结果与40例匹配对照的结果进行比较。所有患者均连续评估14±3年，并在初始评估后8±3年进行随访超声心动图检查。所有病例均进行抗心磷脂抗体和狼疮抗凝物的系列测定。
在初始和随访超声心动图检查之间，有瓣膜异常的SLE患者数量从39%增加到73%，但只有7例患者（12%）出现严重瓣膜反流。严重瓣膜反流与高水平IgG抗心磷脂抗体的存在显著相关（P = 0.001）。严重瓣膜反流患者中风、外周栓塞、瓣膜手术需求和死亡的综合发生率为86%，而无严重瓣膜反流患者为25%（P = 0.003）。
在SLE患者中，高水平IgG抗心磷脂抗体的存在与严重瓣膜反流的发生、血栓栓塞事件的高发生率以及瓣膜手术需求相关。
